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This may be explained by trait-to-trait causal effects, shared genetic and environmental factors, or both. We studied a sample of \u2264 19,125 twin children and 2,150 siblings from the Netherlands Twin Register, assessed at ages 7 and 10. Children with a condition, compared to those without that condition, were 2.1 to 3.1 times more likely to have a second condition. Still, most children (77.3%) with ADHD, dyslexia, or dyscalculia had just one condition. Cross-lagged modeling suggested that reading causally influences spelling (\u03b2 = 0.44). For all other trait combinations, cross-lagged modeling suggested that the trait correlations are attributable to genetic influences common to all traits, rather than causal influences. Thus, ADHD, dyslexia, and dyscalculia seem to co-occur because of correlated genetic risks, rather than causality.<\/jats:p>","DOI":"10.1177\/09567976241293999","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T04:00:28Z","timestamp":1742270428000},"page":"204-217","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["*Co-Occurrence and Causality Among ADHD, Dyslexia, and Dyscalculia"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5860-5745","authenticated-orcid":false,"given":"Elsje","family":"van Bergen","sequence":"first","affiliation":[{"name":"Department of Biological Psychology, Vrije Universiteit (VU) Amsterdam"},{"name":"Research Institute LEARN!, VU Amsterdam"},{"name":"Amsterdam Public Health Research Institute"},{"name":"CREATE and PROMENTA, University of Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9042-7419","authenticated-orcid":false,"given":"Eveline L.","family":"de Zeeuw","sequence":"additional","affiliation":[{"name":"Department of Biological Psychology, Vrije Universiteit (VU) Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Waterloo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7099-7972","authenticated-orcid":false,"given":"Dorret I.","family":"Boomsma","sequence":"additional","affiliation":[{"name":"Department of Biological Psychology, Vrije Universiteit (VU) Amsterdam"},{"name":"Amsterdam Public Health Research Institute"},{"name":"Amsterdam Reproduction and Development Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eco J. 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